hydrotherapy

Question 1

what is hydrotherapy?

Answer 1

application of water for treatment of physical dysfunction

Question 2

what is the whirlpool effective at?

Answer 2

its effective at applying heat or cold to irregularly shaped areas

Question 3

what is the whirlpool?

Answer 3

an enclosed stainless steel tank for applying hydrotherapy

Question 4

what does the whirlpool allow?

Answer 4

allows patients to perform ROM while receiving either heat or cooling modality while utilizing therapeutic effects of water

Question 5

what does a warm whirlpool promote?

Answer 5

muscle relaxation and allow for an increase in ROM and strength

Question 6

what do cold whirlpools do?

Answer 6

reduce inflammation

Question 7

a whirlpool at what temp and for how long is equivalent to applying an ice pack?

Answer 7

50ºF and 20 mins

Question 8

what are the effects of the whirlpool?

Answer 8

reduction in pain via gate control theory through stimulation of cutaneous a-beta receptors

Question 9

how can whirlpools cause edema formation?

Answer 9

when a patients limb is in the whirlpool it is in a dependent position which can promote edema formation

Question 10

how do we avoid edema forming?

Answer 10

need to exceed the diastolic BP to prevent edema from forming

Question 11

how do we figure out how to prevent edema from forming?

Answer 11

if there is .73mmHg of force per 1cm of depth and a mid calf emersion is approximately 25 cm that would be 18.25 mmHg of pressure. so ideally we would need about 110cm (3.5 feet) to get 80.3 mmHg

Question 12

T/F: we dont apply cold whirlpool treatment in acute injuries where edema is still forming

Answer 12

true

Question 13

how do whirlpools increase ROM?

Answer 13

increased blood flow, reduced pain, and reduced edema all increase ROM of a joint
gravity assisted motion secondary to buoyancy of water can assist in increasing joint ROM
also we can set agitator on whirlpool to assist with ROM

Question 14

whirlpools are a ____________________ form of mechanical debridement

Answer 14

non-selective

Question 15

what are some risks patients are predisposed to if using whirlpool to treat wounds?

Answer 15

bacterial cross contamination
damage to fragile tissue formation from high turbine forces
complications in extremity edema when arms and legs are treated in a dependent position in warm water

Question 16

what temperature range should we use for cold whirlpool?

Answer 16

50-60ºF

Question 17

what is the treatment time for cold whirlpool?

Answer 17

10-30 minutes
inital-10 mins
subsequent 20-30 mins

Question 18

how should patients be positioned for cold whirlpool?

Answer 18

gravity dependent position

Question 19

what can we use in cold whirlpool to protect the toes?

Answer 19

a toe cap

Question 20

what is an advantage to cold whirlpool?

Answer 20

able to treat big surface area

Question 21

what is a disadvantage to cold whirlpool?

Answer 21

body part is in dependent position

Question 22

what temperature range should we use for warm whirlpool?

Answer 22

104-112º F
adjust for patient comfort and age

Question 23

what is the treatment time for warm whirlpool?

Answer 23

10-30 mins

Question 24

what are some indications for whirlpool?

Answer 24

superficial heating and cooling
water exercise
pain control
in acute and subacute conditions in which you want to exercise during treatment

Question 25

what are some contraindications for whirlpool?

Answer 25

open wound
bleeding
impaired thermal sensation
impaired mentation/cognition
infection in treatment area
recent skin graft/surgery

Question 26

what are some precautions for whirlpool?

Answer 26

same as with thermal modality
cardiovascular/renal conditions- can be used to increase blood flow in people with peripheral vascular disease but need to be careful to not burn them

Question 27

what parts makeup a whirlpool?

Answer 27

turbine
water aerator
water intake
water turbulence adjustment

Question 28

what is some safety to consider for whirlpools?

Answer 28

ground-fault circuit interrupters are required where whirlpools are located
patients should never touch turbine or any of the machinery in the whirlpool

Question 29

how is the whirlpool set up?

Answer 29

should be filled with water if cold then the ice needs to be completed melted
recommended that it be drained and cleaned after each treatment to minimize the potential risks of spreading fungal, viral, or bacterial infections- especially with open lesions

Question 30

why is the whirlpool the most intense application of cryotherapy?

Answer 30

because the body cant develop a thermal barrier on the skin because of the convection effect of the whirlpool so first few treatments PT should remain in the area

Question 31

what is the general procedure for any modality?

Answer 31

determine which application is best
introduction
explain the procedure and why- relate to impairments
expectations- CBAN, decrease in pain/inflammation increase ROM, possible adverse
screen for contraindication
inspect area to be treated
have patient remove jewelery clothing from area
check sensation

Question 32

what is the specific procedure for the whirlpool?

Answer 32

make sure the drain is closed
select temperature for treatment
fill whirlpool 2/3 way
turn on the turbine, adjust aeration, agitation, and direction of the water being pumped
instruct patient to keep away from all parts of the turbine
pad edge of tank with toweling, warn patient that the water is cold, place body part in tank
check patients response verbally and visually about every 2 minutes- remind patient to tell you if area starts hurting or sensation is lost